The NCSL Blog


By Charlie Severance-Medaris

The recent high-profile suicides of Kate Spade and Anthony Bourdain reignited discussions on the factors that cause Americans to take their own lives.

illustration from CDC suicide reportSeveral national media outlets reported that their deaths triggered a 25 percent spike in calls to the National Suicide Prevention Lifeline (800-273-8255).

Amid this national discussion, the Centers for Disease Control and Prevention (CDC) released details on the rising rate of suicide in the US.

Suicide rates increased significantly in 44 states from 1999-2016, rising by more than 30 percent in half of all U.S. states. Nevada stands alone as the only state to see a decrease in suicide.

Suicide, now the 10th leading cause of death in the U.S., accounted for nearly 45,000 lost lives in 2016, according to the CDC’s analysis. In addition to the emotional toll of suicide on communities and families, suicides and self-harm injuries cost the nation approximately $70 billion per year in direct medical and work loss costs.

While suicide is often associated with mental illness, more than half of all people who die by suicide have no known mental health condition, according to the CDC release. Researchers agree that multiple factors can affect an individual’s level of risk, such as economic hardship, relationship problems, substance use disorders, physical health problems, recent crises and a host of other factors.

Middle-aged, white men are most at risk of dying by suicide, according to CDC data. Overall suicide rates are lower for younger Americans. Suicide, however, is still the third leading cause of death for Americans under the age of 25. Rural communities and communities with distressed economic conditions also show higher rates of suicide.

Other CDC data show that gender, race, sexual orientation and other factors influence risk of suicide. Black youth ages 5 to 12 are nearly twice as likely as their white counterparts to die by suicide, and LGBT teens attempt suicide at a rate roughly five times higher than their heterosexual peers.

With increased national scrutiny of the nation’s mental health, many policymakers seek information to address suicide in their communities. In 2017, the CDC released a package of strategies states and communities can use to reduce suicide risks. These evidence-based strategies include:

  • Connect patients with mental health care: State-level suicide rates have been found to correlate with general mental health issues such as depression. Strategies to increase access to care include covering mental health services under insurance plans and working to address provider shortages in underserved areas.  
  • Teach coping and problem-solving skills: Learning life skills helps individuals cope and adapt to adversity. Social-emotional learning programs can be used in schools, faith-based communities and other community organizations to teach youth problem-solving skills, emotional regulation and conflict resolution. Parenting and family relationship programs can strengthen parenting skills and improve children’s communication and interpersonal problem-solving skills. 
  • Strengthen economic stability: Suicide rates increase during times of economic hardship and decrease in rosier economic climates. Financial strain caused by uncertain employment situations or job loss can influence suicide risk or exacerbate existing risk factors. Providing unemployment benefits and other forms of temporary assistance can help alleviate the stress and uncertainty of economic hardship. Efforts to stimulate job growth in rural and other economically distressed communities can help provide relief as well.  
  • Promote connected environments: Increasing social connectedness may protect against suicidal behaviors by decreasing isolation, encouraging coping behaviors and increasing a sense of belonging. Connectedness may also increase individuals’ access to formal supports and resources. Studies have shown that participants in community engagement activities such as religious activities or volunteer activities or volunteer opportunities report lower levels of stress (a suicide risk factor), and higher levels of physical activity (a protective factor).

The CDC maintains various resources related to suicide and suicide prevention on their website.

Map from CDC on suicide rates

Charlie Severance-Medaris is a policya associate in NCSL’s health program.

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This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.